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Stay informed: Doing homework as a patient comes in handy for RN

Thursday May 22, 2014
Dyanne Rodriguez, RN
Dyanne Rodriguez, RN
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As a nurse, there are times when you help others and times you need to help yourself. Just recently I experienced a situation in which I needed to help myself as a nurse. As I like to say, I had to keep it close to home.

I donít always see my regular doctor, who practices in an office with several other physicians. After being examined by one of the other physicians, I was informed I had a streptococcal infection and needed to be treated with IV antibiotics. This was unexpected news, so I listened and took the information home.

At home, I did some thinking and did my homework. I read medical forums, scientific journals and public health sites. I gathered as much knowledge as I could to educate myself about treatment and its outcomes for streptococcal infection.

I found that the recommended treatment of choice for my particular situation was a first-generation cephalosporin, delivered intravenously, as long as there was no history of anaphylaxis. I knew I had experienced an adverse reaction as an infant to cephalosporins, but had no history of anaphylaxis, and I had been treated with cephalosporins as a young adult.

I brought my knowledge with me to my next appointment, at which my doctor wanted to treat me with an IV glycopeptide antibiotic. Remembering what I had read, I brought up the medication choices I had as a patient.

The physicianís reply shocked me. She said I could either take the antibiotic she was recommending or refuse to be treated. When I questioned her rationale, she said those were the only options.

The next morning, I brought photocopies of physician association and public health guidelines that related to antibiotic regimens for streptococcus into the doctorís office with me. I approached the nurses with my concern. I was requesting to be treated with an antibiotic that Iíd taken in the past and that is also the recommended antibiotic treatment, according to the data.

The nurse asked me to wait in the reception area and after some time, a different physician who was covering that day said she would speak with me. Eventually, the physician brought me into the patient room and said she would prescribe the medication I had requested.

I asked why I was not given the option at my first appointment. She said some physicians might not want to offer cephalosporins to patients with a history of allergies to that class of antibiotics, because of the possibility of anaphylaxis.
She added that physicians need to do more complete patient assessments to determine which treatment would be most appropriate. That last part was very true: I was not asked nor given the opportunity to discuss my antibiotic history with the previous physician.

I hope my story sends a message: Do your homework and bring it with you. As a healthcare professional I have studied for many years to keep myself informed. Even with this knowledge and the additional research I did, bringing up my concern to my physician required a lot of extra effort. The large portion of society that does not have healthcare knowledge probably would have an even more difficult time.

I hope nurses will continuously educate themselves as healthcare professionals, and assist others in learning about their healthcare so that they, too, are knowledgeable when they meet with their provider or need procedures, tests or surgeries. To both clinicians and patients alike: When you are not sure about something, ask questions.


Dyanne Rodriguez, RN, BSN, hails from North Andover, Mass., and is pursuing her MPH at the University of Alaska Fairbanks. She has worked in long-term care and acute care, in both pediatric and adult clinical areas. She participates in community work, including visiting the Dominican Republic with a medical team. Post a comment below or email editor@nurse.com.